Patients deserve peace of mind

April 26, 2014

In November, the Pennsylvania House of Representatives passed H.B. 1603 by an overwhelming 131-67 vote, with broad bipartisan support - 70 Republicans and 61 Democrats voted yes.

This bill, which now awaits action in the state Senate, requires that anesthesia be administered by a physician anesthesiologist or other physician, or by a nurse anesthetist under the supervision of a physician.

Physician supervision is not a new concept.

State Health Department regulations already impose these same requirements. The purpose of H.B. 1603 is to put current practice into law so Pennsylvanians will be assured that, while they are unconscious and vulnerable, professionals with the highest available level of medical training and experience are there to deal with any unexpected life-threatening issues - that a physician is in charge when seconds count.

Anyone who undergoes a surgical procedure knows a certain feeling of trepidation.

As advanced as modern medical science may be, it's unsettling to know you will be placed into a level of unconsciousness for a time while the medical team uses tools and procedures to enter and work inside your body.

We take comfort in the belief that a combination of advanced medical training and experience will prevail, and that when we wake up from surgery, all will be well.

Yet, things can - and sometimes do - go terribly wrong.

Most people don't think of general anesthesia as a drug-induced coma. But that's what it is. Patients usually don't pay much attention to who is about to put them into the coma before the surgery can begin. They should.

The person or persons administering the anesthesia must know how to fix any problem that arises, quickly and effectively. They must be fully prepared to bring back the patient they've put under. There may only be time for one rescue attempt.

Physicians undergo at least 10 years of education and medical training before practicing anesthesia. Nurse anesthetists get two or three years of post-graduate training in anesthetics. Part of the reason they spend less time in training is because they are NOT studying diagnosis and treatment of medical conditions. That's where a physician comes in.

If a patient in an induced coma unexpectedly takes a turn for the worse, a physician anesthesiologist is trained to diagnose, make decisions and take actions that only a physician is prepared to do. Quite simply, a physician should lead the rescue team.

Pennsylvanians deserve assurances that, as they undergo anesthesia, they will be in the best-trained hands. They need to know that if something happens, a physician will be in charge. They need to know that, when seconds count, their doctor is there.

H.B. 1603 is now in the Senate Public Health & Welfare Committee. The committee can, and should, act on the bill and report it out for a floor vote in the full Senate. Then, and here's the bottom line, the Pennsylvania Senate should immediately approve H.B. 1603 and send it to the Governor for his signature.

The writer is the president of the Pennsylvania Society of Anesthesiologists.